Overview of complete Achilles tendon tear
[NB1]
- Complete Achilles tendon tear is often related to trauma, particularly sports-related (whereas microtears and partial tears are usually related to tendinopathy).
- Diagnosis is made on clinical examination.
- Initial management should involve the POLICE regimen [NB2], analgesia and nonweightbearing.
- Advise patients about nonsurgical and surgical treatment options.
NB1: This list is a summary guide only; refer to full text.
NB2: POLICE = Protection, Optimal Loading, Ice, Compression, Elevation.
Complete tear (also known as rupture) of the Achilles tendon typically occurs in males aged 30 to 50 years. Male to female injury ratios range from 2:1 to 12:1. Running, jumping and agility activities, involving eccentric loading, rapid acceleration and explosive contractions, are the usual mechanisms of injury. Approximately 80% of acute Achilles tendon tears are complete and 20% are partial.
Complete tear has also been described as an adverse effect of fluoroquinolone antibiotics (eg ciprofloxacin) in patients older than 60 years. Use of oral corticosteroids also increases risk.
People with a history of Achilles tendinopathy often present with acute pain associated with partial tear of the Achilles tendon or progression from a partial to a complete tear. Management for a partial tear is as for tendinopathy; see Management principles for tendinopathy.